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[骨质疏松性股骨头小梁的破骨细胞吸收:扫描电子显微镜研究]

[Osteoclastic resorption of trabeculae in osteoporotic femoral head: a scanning electron microscopic study].

作者信息

Chai B F, Tang X M, Zhou W R

机构信息

Shanghai Institute of Traumatology and Orthopaedics.

出版信息

Zhonghua Wai Ke Za Zhi. 1994 Oct;32(10):621-5.

PMID:7750424
Abstract

Osteoclastic resorption was studied by scanning electron microscopy on the trabeculae of femoral heads collected from 7 cases of aged women at an average age of 72.4 years, who underwent endoprosthetic replacement for intracapsular fracture of femoral neck. Femoral head trabeculae from 3 young adults killed in traffic accident served as control. The trabeculae of the femoral head formed round or roundish arch structure. The columnar trabeculae of the femoral head in the aged women showed overt osteoclastic resorption, manifesting thinning, tapering and perforation. The icicle-like trabeculae then became rounded, lost height and eventually turned into a small tubercle. As a result, the inter-trabecular space enlarged markedly. Under high magnification, on the trabeculae could be discerned oval, narrow oval or spindle-shaped Howship lacunae, which were various in size, depth and content, but all revealed punch-out edge. Around the lacunae the collagen fibril lamella normally covering the quiscient bone surface became resorbed sooner or later. During bone resorption, the inorganic component of the bone matrix were first dissolved and resorbed leaving behind rough and irregular collagen fibrils; nevertheless, the collagen might be degraded and resorbed first with residual inorganic crystals and irregular bone nodules. Then emerged in the Howship lacunae and surrounding area newly formed collagen fibrils and bone tissue, signifying reversal and new bone formation phases following the the bone resorption phase. In the aged women, however, this phenomenon was rather infrequently encountered, thereby leaving the bone turnover always in a negative balance state.

摘要

通过扫描电子显微镜对7例平均年龄72.4岁的老年女性股骨头小梁进行破骨细胞吸收研究,这些女性因股骨颈囊内骨折接受了人工关节置换术。选取3例因交通事故死亡的年轻成年人的股骨头小梁作为对照。股骨头小梁形成圆形或近似圆形的拱形结构。老年女性股骨头的柱状小梁显示出明显的破骨细胞吸收,表现为变薄、变细和穿孔。冰柱样小梁随后变圆,高度降低,最终变成小瘤状。结果,小梁间隙明显增大。在高倍显微镜下,在小梁上可辨认出椭圆形、窄椭圆形或纺锤形的Howship陷窝,其大小、深度和内容物各不相同,但均显示出凿孔边缘。陷窝周围通常覆盖静止骨表面的胶原纤维板迟早会被吸收。在骨吸收过程中,骨基质的无机成分首先溶解和吸收,留下粗糙和不规则的胶原纤维;然而,胶原也可能首先降解和吸收,留下残余的无机晶体和不规则骨结节。然后在Howship陷窝及其周围区域出现新形成的胶原纤维和骨组织,表明在骨吸收阶段之后进入了逆转和新骨形成阶段。然而,在老年女性中,这种现象很少见,从而使骨转换始终处于负平衡状态。

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